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UnAffordable Healthcare Act

The GOP’s new double-whammy bills to both repeal and replace the ACA, which Trump is affectionately calling TrumpCare, [insert eye roll here, please] is the Republican’s answer to solving the majority of society’s woes. Amazingly, this bill could drastically reduce the number of homeless, raise the median income in our country to highs never seen before, and make both Social Security and Medicare solvent, permanently! Really! How is that, you ask? Let’s take a look and break it down!

The Bill promises massive cuts to Medicaid and to phase out the Medicaid Expansion over the next three years, with complete elimination by 2020. Hmm, they say hindsight is 20/20. I wonder what we will look back and see then. The Medicaid Expansion portion of the ACA extended coverage to approximately 11 million low income US Citizens. That is a lot of people who will begin to see a reduction in their healthcare options until it dwindles to nothing by 2020. This also includes repealing the subsidies the government now provides to help lower income people pay for deductibles and out-of-pocket expenses for insurance purchased on the marketplace.

The new Trump Doesn’t Care Act will also de-fund Planned Parenthood, intentionally targeting women’s reproductive healthcare, specifically preventing them from offering services like birth control (click here so I can say, “I told you so.”) and mammograms to more than 2.5 million women across the country.

The plan offers a tax incentive to Insurance Companies who PAY THEIR CEO MORE THAN $500,000 A YEAR. Because, yeah, that somehow helps families with their healthcare costs. Yip. Now, instead of subsidizing premiums so lower income families can afford healthcare coverage, we are going to subsidize and reward Insurance Carriers for paying their CEO’s more money! Now that is how you help the working class. I don’t know why we didn’t see that obvious connection before!

While the new bill does keep the provision protecting people with pre-existing conditions, that only stays effective so long as the person maintains continual health coverage. If it ever lapses for two or more months, that protection is gone. FOREVER. So, people who lose health coverage through their work (we will get to why that will likely be popular shortly) or are victims of the Medicaid Expansion Rollback, or who find their insurance plan suddenly costs more than than their rent or mortgage, will have precious little time to replace it with something else. Oh, and it gets even better! If your coverage happens to lapse for two months or more, insurance companies not only can exclude your pre-existing condition, you are penalized by being charged a 30% higher premium for an entire year. Now that money doesn’t go to the IRS or the government to help with healthcare programs and subsidies. No, the insurance company gets to keep it, just because. So, this measure will ensure that lower income people who lose their health coverage and can’t find a replacement that is affordable quickly (if at all) will likely never be able to afford medical insurance. But hey, they probably don’t want access to affordable healthcare anyway. If poor people really wanted healthcare, then they wouldn’t be poor, right?

The GOP solution to no more subsidies is a tax credit based on age and income. So, if you are in your twenties and make less than $75K a year, you might qualify for a $2,000 tax credit. That number increases with your age up to $4,000 per year if you are 60+. A family has a maximum tax credit of $14,000. That doesn’t sound too terrible, right? If you are in your twenties, that is about $166 a month for health insurance. But here is the catch: only people who do not have a healthcare plan available to them through their employer and who do not receive any form of government provided healthcare qualify for this tax credit. So, even if you are paying $300 a month for your portion of employer provided insurance, you do not qualify. Even if you are paying the full price for your Medicare premium, you do not qualify. And, under this bill, insurance companies can charge much higher premiums, literally five times the cost, for older people than younger. Last time I checked, $2,000 multiplied by five was a lot more than $4,000. But wait! There’s more to this infomercial! The GOP has foreseen that some people might not be able to afford these skyrocketing premiums, so they are allowing insurance companies to offer a vastly scaled back alternative, with high deductibles and only catastrophic coverage. So, these people can see only a small increase in their premium if they accept reduced coverage down to almost nothing. That’s a deal, right? Paying more for less! The new GOP answer for healthcare options.

Let’s take a closer look at what that tax credit might actually accomplish, shall we? How about the loss of health benefits through your employer? But, wait, you work for a large company, they are required to provide health insurance benefits to their employees, so you are good. Guess again. This bill repeals that requirement, which will have significant repercussions to healthcare. First, large companies who enjoy paying a vast number of employees poverty wages (looking right at you, Wal-Mart) will no longer be required to offer health insurance to full time workers. Those workers will not be compensated for that loss in their paycheck. They will literally just be working for even less money. Sure, they can get the meager tax cut that will not come anywhere near covering the average medical plan. So, in turn, the poor just got poorer. Companies who offer benefits packages as incentives to their employees may also feel less need to stick with the healthcare business. Here is why. Healthcare benefits, both what the employer pays and the the employee contribution to it, have thus far been non taxable. They have always had the option of just giving their employees a lump sum or an allotted amount to purchase their own benefits, but that money is taxable, which means the employee gets a big chunk less money and has to make up that difference out of their own pocket. With the tax credit, it will basically offset that tax burden for the employee and they can get whatever coverage they want. That doesn’t sound so bad, does it? Except, that $10,000 extra they give you for health insurance means your salary just went up $10,000. It would effectively mean that anyone making $65,000 before would see a reduction in their tax credit. It also means they will not be able to collectively bargain for insurance rates to get better premiums and the older they are, the higher that rate. Yet, the tax credit incentive is likely to motivate many companies to reduce their own human resources costs by eliminating healthcare packages. Oh, and if your employer provided healthcare is terminated, you will have less than two months to replace it. It will likely mean the phasing out of healthcare incentive packages provided by employers. When you take away collective bargaining, there will be nothing to keep premiums in check.

Oh, and we certainly cannot forget, that if you purchase a plan on the open market that happens to cover abortions, you are not eligible for the tax credit, either.

The Congressional Budget Office says it cannot score the bill. Which basically means they have no way of calculating how much it would cost. Well, I have a good idea about that. Likely, not a whole lot. I am betting it will be really cheap. Why? Well, a large portion of people now covered under the marketplace will not be able to even remotely afford the non-subsidized premiums. Now, so you can get a handle on this, right now a very basic health insurance plan on the marketplace for a married couple is running about $750 a month. That is what the Insurance company says it really costs. (this is variable, of course, but an example from someone I know who purchases insurance through the ACA on the marketplace. So it is a real figure). With the ACA subsidies, that premium is reduced to $73 per month. Now, this is reasonably affordable for a young couple who doesn’t make a ton of money. They, and pretty much everyone like them, cannot afford the non-subsidized marketplace premiums, even with the tax credit. Even if they each get a $2,000 tax credit, that will only be seen next year when they file their taxes, they will still need to come up with and additional $4,124 over what they were paying before for the exact same coverage. That is not reasonable, which means they will be unlikely to continue coverage, just like everyone else in their situation. If they do not continue their coverage, they will not be eligible for the tax credit. Which means, now you see it, the government spends nothing. So, when you include the dramatic federal decreases to Medicaid and the tax credit that few people will ever use, this plan gets cheaper all the time.

The Republicans out touting this bill, trying to boost public support and whip the party into backing it, really aren’t even attempting to hide their disdain for the poor, or the fact that literally millions of US Citizens will lose access to affordable healthcare. House Representative Jason Chaffetz, (R) from Utah, has been plastered across the news and internet promoting the idea that the poor just don’t deserve healthcare. I hope this quote is painted across billboards when he is up for re-election. “Maybe rather than get that new iPhone that they just love and they want to spend hundreds of dollars on, maybe they should invest in their own healthcare.” Yes, Rep. Chaffetz, because that makes so much sense. Because there are so many marketplace policies out there for $31 a month. That is the equivalent of what these poorpeople are paying for that iPhone compared to the $325 a month you think they should be able to invest in their healthcare. The GOP shows, every time they open their mouths, that they have no clue how the majority of us live. Most people do not have the money to go out and buy the new iPhone, Rep. Chaffetz. They pay it out over a two year contract with a service provider. They don’t have an extra $749 just sitting around. But two months of your healthcare plan would pay for that phone. The GOP just doesn’t believe poor or low income people deserve healthcare. They don’t deserve to have the same kinds of fun or nice things the rich do. They don’t deserve fair, livable wages. They don’t deserve reproductive rights. They don’t deserve equal opportunities at education. They don’t deserve decent food. They don’t deserve clean water. They don’t deserve safe housing. They don’t deserve the AmericanDream, because, if they did, they wouldn’t be poor, would they? We get it, Chaffetz. We understand you perfectly.

So, you see, with millions of people priced out of health coverage options and no Medicaid safety net for the majority of them, the inflated rates and reduced coverage being proposed to Medicare (and again, loss of the Medicaid safety net for the majority), people will lose access to our system of overpriced, commodity based, healthcare. People will die. A lot of people will die. And the people who die will be the poor and lower income, the homeless and the elderly. So that just solves all the GOP’s problems, doesn’t it? They can literally reduce homelessness, raise the median income (because you can’t average in the income of dead people) and make Social Security and Medicare permanently solvent (again, you don’t need to pay benefits to dead people) without spending hardly anything! They may have to kill off a few million ‘undesirable leeches,’ but that’s easy, just pass the UnAffordable Healthcare Act to do it. Problems solved.